A few weeks ago one of my Thai friends came over. He had been bitten by a soi dog. A good firm nip with tooth marks cleaning breaking skin in two places.
I told him he needed rabies shots and a tetanus shot. Since he comes from an upcourntry province his gold card is affiliated with a local clinic there.
First they cleaned the wound.
After a bite that breaks skin, in someone not previously vaccinated they give a shot of rabies immune globulin (a blood product that contains antibodies against rabies), which gives immediate, short-term protection around the wound site.
They also do a small antigen allergy test prior to the series.
Then they give a series of 5 shots on day 1,3,7,14,28.
The fees at the local government hospital are not excessive but Around 1000 baht for the blood product, and then about 300 for each of the 5 rabies shots and something like 100 baht for the tetnus shot.
I took him to a local private hospital that caters to Thais and Russians.
The Cost on day one was about 4000 baht for the wound cleaning, the first shot in the rabies series, the antigen test, the immune globulin, and the tetnus shot. and each of the following shots were visits were 720 baht to 800 baht depending on wheather it was both rabies vacine and tetnus or just the rabies vaccine..
Now if someone has a pre-exposure series of three rabies shots, the blood product is not necessary. This should be an important consideration if you want to avoid blood product exposure. There is a small but not nonexistent risk of contamination by various viruses (Hep B and HIV spring to mind) in blood sourced virus products.
Also the PE shots can be part of your regular checkups and so would only add 720 to the cost of an office visit at a private clinic and less at a government hospital. Once every five years I get a booster. Though not really necessary.
The chief advantage of getting the 3 shot series before an incident is that you don't have to take the riskier immune globulin shot. It also gives you a longer window to seek treatment since you have some residual protection before the vaccine booster will stimulate your immunity to re- recognize rabies.
For me it also gives me peace of mind that when a friends dog licks me, I don't freak out and run to the hospital for a rabies shot as no skin break with dog saliva merely warrants a good hand washing.
As for local soi dogs that stray around my house, once every year to 18 months I drop by the local vet and buy prefilled syringes with the vaccine and vaccinate them myself. I just put down some good dog food and while they are eating, a quick shot in the area under the fur toward the top and back of the neck. They don't even notice. Much easier than trying to get them to the vet even though there is one a few hundred meters away.
The rabies shots for pre-exposure are not covered by your Thai Health Insurance, all rabies and Tetnus shots should be covered under your accident cover if your get it within 24 hours of the bite. Most Thai plans even inpatient only ones cover a limited amount of emergency opd treatment. The ajarn.com plan has a 8000 baht limit and some rules. Check your card to see the cover.
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